MEDICARE: DR. ALYSSA DENNIS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR009642	GA

General Provider Information

NPI Number	:	1811345937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALYSSA DENNIS D.C.

Provider Business Mailing Address
First Line	:	6425 POWERS FERRY RD STE 175
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2964
Country	:	US
Telephone Number	:	678-831-5064
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 POWERS FERRY RD STE 175
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2964
Country	:	US
Telephone Number	:	678-831-5064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2016
Last Update Date	:	06/25/2020

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